Paul Edward Jansen, PH.D.
Individual provider Active NPI Clinical Psychologist · Norwood, MA
NPI 1215097548 · NPPES record last updated May 2, 2012
Key facts
- NPI
- 1215097548
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 864 (MA)
- Practice address
- 11 Vanderbilt Ave
Suite 240
Norwood, MA 02062-5056 - Phone
- (781) 769-5050
- Fax
- (781) 784-2927
- NPI assigned
- Dec 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1971
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
11 Vanderbilt Ave
Norwood, MA 02062-5056
Phone (781) 769-5050
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120901000015 | MA | Practitioner - Clinical Psychologist | 8628225232 | Practice locations: Norwood, MA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 864 | MA | MD | Drama Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 864 | MA | |
| Clinical Psychologist | 103TC0700X | 864 | MA | Yes |
| Family Psychologist | 103TF0000X | 864 | MA | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 864 | MA |
Addresses
Primary practice location
11 Vanderbilt Ave
Suite 240
Norwood, MA 02062-5056
Mailing address
95 Moose Hill Pkwy
Sharon, MA 02067-1730
Phone (781) 784-1796
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0503576 | Medicaid | MA |
Other providers in Norwood, MA
- Ben Jackson
- Alan Jacobson
- Jami Gantz Jain
- Manan Jain
- Barry James
- Anu G Jayaraman
- Lauren A Jayasinghe
- Besher Jazmati
- Marie France Jean Pierre
- Jef Core Inc
All providers in Norwood, MA · Clinical Psychologist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.